It’s Easy to Blame Stress for Heart Disease, but Bad Habits May Be Equally Responsible

The article (“Heart Disease in the Executive Suite,” Dec. 10) was informative, but there was only one brief reference to one of the most significant causes of heart attacks--cigarette smoking.

The statement by the specialist in cardiac rehabilitation that “the business person takes control and by choice joins a cardiac rehabilitation program” is not entirely true. The business person usually has health insurance, which pays for this program. Of the $2.5 billion spent on coronary bypass surgery each year in the United States, 99% of these patients have health insurance. I don’t think poor people without health insurance are immune to heart attacks.

A major portion of the article is devoted to the stress factor as the significant cause of heart attacks. Stress is a significant factor, but it also helps us to have an excuse for taking poor care of our bodies for many years.

There is no single cause for heart attacks. However, we do know that there are several risk factors in developing coronary heart disease. For many years it has been known that the chances of having a heart attack before age 65 are 1 in 2 if a person has two or three of the following risk factors: cigarette smoking, high serum cholesterol, high blood pressure, diabetes mellitus, poor heredity (close relative with heart attack before age 50), physical inactivity, obesity and excessive stress. For those who do not have these risk factors, heart attacks before age 65 are uncommon.

ROBERT J. HAMMOND, M.D.

Santa Ana